ࡱ> q` xbjbjqPqP `::p-$TTTPbT\TtVV(VVVaZaZaZ$haZYaZaZaZVVӋQ_Q_Q_aZHVVQ_aZQ_Q_ЅVV ~=тT[؃60w\hwlЅwЅ4Q_aZaZaZ^XaZaZaZaZaZaZaZdNTT LOCAL INTERAGENCY AGREEMENT BETWEEN SANTA CLARITA VALLEY SPECIAL EDUCATION LOCAL PLAN AREA AND LOS ANGELES COUNTY CALIFORNIA CHILDRENS SERVICES April 20, 2007 Activity  Special Education Local Plan Area/ Local Education Agency Los Angeles County California Children Services MTP A. Coordination of Services/ Identification of Liaison California Code of Regulations, Title 2, Division 9, Article 5, Section 60310 [a](1) A.1  A SELPA liaison (see glossary) shall facilitate and monitor interagency collaboration and coordinate services between agencies. A MTP liaison (see glossary) shall facilitate and monitor interagency collaboration and coordinate services between agencies. B. Referrals & Assessments Ca. Code of Regulations, Title 2, Div. 9, Article 5, Sections 60300 [j], 60310 (2), 60320, 60323 Title 22, Chapter 4, Sections 41800-41876, R-40-92E  B.1  The SELPA shall utilize the LEA/SELPA Program Referral (see attachment) to refer students to CCS, birth to 21 years of age who may have or are suspected of having a neuromuscular, musculoskeletal or other physical impairment, requiring medically necessary OT and/or PT. Students referred to the SELPA for assessment of fine and gross motor or physical skills shall be considered for assessment by either the SELPA or by CCS depending on the information contained in the referral and the students documented physical deficit. CCS shall accept LEA/SELPA Program Referrals (see attachment) for students who have or are suspected of having a MTP eligible condition and who may require medically necessary OT and/or PT. If educationally necessary therapy deficits are suspected, CCS shall suggest that the parent/legal guardian contact the students school of attendance (see glossary) for consultation regarding their students educational program. If the student is receiving therapy services at a MTU, the MTU shall also send a Therapy Plan to the students school of attendance with the same recommendation.  B.2  The SELPA referral to CCS shall include the students medical diagnosis, current medical records, parental permission for exchange of information between agencies and a signed application for the CCS program (see attachment).  Upon receipt of a referral, CCS shall determine if the referral contains the required elements. If the referral does not meet the interagency referral criteria, CCS shall notify the referral source and the parent/legal guardian of that fact within 5 calendar days of receipt of the referral. If the referral contains the required elements, CCS shall evaluate the students eligibility for the MTP according to CCS program policies and guidelines. CCS shall notify the referral source and the parent/legal guardian whether a student is eligible or ineligible for the MTP within 5 calendar days of the receipt of a complete referral. B.3  If the SELPA determines that a referral to CCS is not appropriate, the SELPA shall propose an assessment plan to the parent/legal guardian. The SELPA shall assess individuals according to requirements of federal and state laws. If CCS determines the student has a MTP eligible condition, the MTP shall propose a Therapy Assessment Plan to the parents and obtain written consent for assessment for medically necessary OT and/or PT. Upon receipt of the parent/legal guardians written consent for the Therapy Assessment Plan, the MTP shall send a copy of the parent/legal guardians consent to the LEA. The parent/legal guardian shall sign this Therapy Assessment Plan not more that 15 calendar days following the determination of the students MTP eligible condition. CCS shall assess all children who are MTP eligible to determine their need for OT and/or PT in accordance with State CCS standards and comply with the requirements of state laws relative to the assessment of children with physical impairments. Upon completion of the assessment, the MTP shall send a copy of the OT and/or PT Evaluation and proposed Therapy Plan followed by the approved Therapy Plan to the LEA and parent/legal guardian. C. IEP Participation and Procedures Ca. Code of Regulations, Title 2, Div. 9, Section 60310 [c] (4,5,6,7) 60325 Gov. Code Section 7572 Program Advisory, CDE, 1995  C.1 Upon receipt of the proposed Therapy Plan indicating a proposed change in the MTP OT and/or PT treatment, the LEA shall schedule an IEP. As per Title 2, the LEA shall provide 10 calendar days written notice to the MTU/MTU-S supervisor prior to an IEP team meeting for an MTP eligible student when MTP participation will be requested. The notice shall indicate if the MTU/MTU-S therapist is requested to attend. After the students assessment is completed, a copy of the OT and/or PT Evaluation and the proposed Therapy Plan shall be sent to the LEA and the parent/legal guardian. The MTP shall indicate on the Therapy Plan form if there is a proposed change in the students treatment plan. The MTP shall provide 5 calendar days notice to the LEA and the parent/legal guardian via an approved Therapy Plan of a decision to increase, decrease, change the type of intervention, or discontinue MTP services. The MTP shall designate an MTU/MTU-S therapist or designee to participate in the IEP meeting, when requested by the LEA or parent/legal guardian. The MTP shall provide the parent/legal guardian and the LEA with a copy of the Therapy Plan and the OT/PT Evaluation. These documents shall include:The students present level of functional performance; The proposed functional goals to achieve a measurable change in function or recommendations for services to prevent loss of present function and documentation of progress to date; The specific related services required by the student including physical therapy or occupational therapy intervention, treatment, consultation or monitoring The proposed initiation, frequency and duration of the services and The proposed date of medical reevaluation.  C.2 The LEA shall provide to the MTU supervisor copies of any notices from the parent/legal guardian or LEA of the intent to include an attorney in the IEP meeting.  The MTP shall contact the LEA to determine the need to reschedule the IEP meeting immediately after receiving the LEA or parent/legal guardian notice of the intent to include an attorney in the IEP meeting. C.3 The site, where the IEP meeting is being scheduled, shall arrange for a teleconference if necessary for MTP participation.  When an MTU/MTU-S therapist is unable to attend an IEP meeting, a MTP designee shall be available by teleconference at a designated time, mutually agreed upon by the MTP and the LEA. C.4 The LEA shall convene an IEP team meeting to determine if the medically necessary therapy services documented in the approved Therapy Plan are necessary for the child to benefit from special education and therefore, should be included in the IEP. The participation of the MTU/MTU-S therapist or designee in the IEP meeting shall be limited to the discussion of the MTP services that assist the student in developing the necessary functional skills to participate in school activities, coordination of services related to the IEP and the decisions regarding medically necessary therapy services made by the MTC team or the students CCS paneled physicians. The MTP therapist cannot agree to the provision of additional services beyond the scope of the proposed/approved Therapy Plan and the discussion shall be limited to factual clinical findings. The therapists may not share confidential information that the parent has discussed with them, or interpret other medical reports that are not within the scope of expertise of their discipline. C.5 The LEA shall send a copy of the IEP to the MTU/MTU-S when therapy services, as stated in the proposed/ approved Therapy Plan, and/or transportation to the therapy site are included in the IEP. D. Least Restrictive Environment  E. Medical Therapy Conference  F. Facilities Needs See Attachment, Facility Space, Equipment and Supplies Necessary for CCS MTP Provision for Specific Fiscal Responsibilities. Ca. Code of Regulations, Title 2, Div. 9 Sections 60300, 60310 [c] (9, 10), [d] (1, 2 ,3), 60330 [a, b, c] Education Code Section 17047 [a] D.1 E.1 F.1 Monitor LEAs/SELPAs to assure compliance with federal and state laws and regulations relating to the least restrictive environment and natural environment. LEA representatives may participate in the MTC when requested by the MTP for the purpose of sharing information. The SELPA shall work with the MTP to mutually plan for the establishment of any new MTU/MTU-S and the modifications or relocation of an existing MTU/MTU-S. Assure that medically necessary PT/OT services are provided in the setting necessary for implementation of the approved therapy plan. The MTP shall send a Notice of a MTC Appointment to the LEA and the parent/legal guardian at least 10 days prior to the scheduled MTC. This form serves as a notification that the proposed therapy plan shall be reviewed at the time the student is examined. The MTP shall recommend to the SELPA liaison the need for an MTU/MTU-S based on the number of hours of prescribed treatment; age and number of children; the residence of the MTP population and the LEAs responsible for providing services for students in the area; the projected growth of the area and the space required to provide medically necessary therapy services.  G. Equipment and Supplies G.1 The SELPA is fiscally responsible for provision of supplies and equipment necessary to support and maintain the function of the MTUs and MTU-S. The MTP and the SELPA shall jointly determine the equipment and supply needs of the MTUs and MTU-S according to the interagency agreement between the State Department of Health Services, CMS branch and the California Department of Education. The SELPA liaison and the MTP liaison shall establish an annual budget for supplies and equipment used by the MTUs and MTU-S.  CCS shall provide the MTUs or MTU-S with the necessary supplies for MTP case management activities, CCS shall provide the MTUs, and MTU-S with the necessary medical supplies to deliver individual treatment of the MTP eligible condition or when the equipment is to become the property of the student. The MTP and the SELPA shall jointly determine the equipment and supply needs of the MTUs and MTU-S according to the interagency agreement between the Department of Health Services, CMS branch and the California Department of Education. The MTP shall provide a report to the SELPA liaison by January 31 of the cases open to the MTU or MTU-S who are receiving services from the SELPA in the month of December. The report shall include the students name, birthdate, address and school of attendance if known. If the MTP does not have written consent to share information, the students information shall not be listed. The SELPA liaison and the MTP liaison shall establish an annual budget. The MTP liaison shall provide the estimated cost of therapy equipment and supplies necessary to support and maintain the function of the MTUs and MTU-S and an inventory of equipment provided by the SELPA. This budget is to be submitted by April 1, for the next fiscal school year (July 1 to June 30). G.2 The SELPA is responsible for the necessary space at the MTU and MTU-S to accommodate the following functions: administration, MTC, comprehensive assessment, private treatment, activities of daily living, storage, and modification of equipment. The SELPA is responsible for the maintenance of the necessary space, equipment and supplies to maintain the function of the MTUs and MTU-S, e.g., utilities including running water and adequate custodial services. The SELPA/LEA shall maintain the same standard of cleanliness and maintenance as the school site where it is located. Utilities, including heating and air conditioning, shall be provided for the entire time while the MTU is in operation. The SELPA/LEA shall negotiate with CCS Administrators for the closure of MTUs on certain holidays/district shut down days. LEA/SELPA shall provide basic bathroom supplies for the MTU ie., paper towels, toilet paper, and soap. The specific MTU and MTU-S space is dependent upon local needs as determined by joint agreement of the State CMS, Los Angeles County CCS and the SELPA, and approved by both the California Department of Education and State Department of Health Services. G.3 Space and equipment of the MTUs and the MTU-S shall be for the exclusive use of MTP staff when they are on-site. The SELPA shall coordinate with the MTP for the use of the space and equipment when MTP staff is not present. Space and equipment of the MTUs and the MTU-S shall be for the exclusive use of the MTP when they are on-site. The SELPA shall coordinate with the MTP for the use of the space and equipment when MTP staff is not present. CCS recognizes that approved school personnel may utilize the treatment room when therapy personnel are not on site.  G.4 The SELPA assumes liability for provision of services rendered by their staff. SELPA therapists shall check equipment prior to use. Space and equipment shall be left in the same manner in which it was found. The MTP assumes liability for provision of services rendered by their staff. MTP therapists shall check equipment prior to use. Space and equipment shall be left in the same manner in which it was found.  H. Transportation Ca. Code of Regulations, Title 2, Division 9, Section 60310 [c](8)  H.1 The LEA shall provide transportation to and from the MTU/MTU-S when included in the IEP as a related service. Transportation needs will be determined by SELPA policy based on Education Code, Section 56195.8.  CCS shall not be responsible for transportation costs for students eligible for the MTP to and from the MTU/MTU-S, when included in the IEP as a related service.Gov. Code Sections 7575 Education Code Sections 41850 (d), 41851, 56342, 56195. H.2 The LEA shall coordinate student transportation with the MTP, school and parent/legal guardian per the SELPA plan based on Education Code, Section 56195.8. The MTU/MTU-S supervisor or designee shall facilitate transportation with the LEA, school and parent/legal guardian. H.3The LEA shall coordinate transportation to and from the MTU/MTU-S based on MTP staff availability.The MTU/MTU-S supervisor or designee shall coordinate scheduling of therapy to the maximum extent possible to facilitate transportation and minimize school disruptions. I. Provision of Services Ca. Code of Regulations, Title 2, Div. 9, Section 60323, 60325 CMS Numbered Letter 11-1600: Duplication of Physician or Therapy Services Being Provided Through the CCS/MTP I.1 The SELPA shall utilize all services available including those available through the MTP before expending funds to provide such services. The LEA shall provide OT and/or PT services as stated on the students IEP that are not designated to be provided by the MTP. The MTP shall provide medically necessary OT and/or PT services as stated in the students current approved Therapy Plan.  I.2 The LEA shall work collaboratively with the MTP in order to avoid duplication and/or coordinate OT and PT services. The MTP shall work collaboratively with the LEA in order to avoid duplication and/or coordinate OT and PT services. CCS is the primary agency to provide medically necessary therapy services if the same services have been identified by both agencies. I.3 The SELPA shall have policies and procedures in place to provide medically necessary OT and/or PT services, when, for any reason, the MTP cannot provide such services as stated in the approved Therapy Plan and contained in the IEP as per Education Code. The MTP shall assure 10 calendar days written notification to the parent/legal guardian and the LEA when the MTP is unable to provide medically necessary OT and/or PT services as stated in the approved Therapy Plan and contained in the IEP. I.4 The LEA shall notify the MTU/MTU-S supervising therapist of any student who transfers into the district with medically necessary OT/PT services included in the students IEP. The MTU/MTU-S supervising therapist shall initiate services for a child transferring from another California county MTP based upon residential eligibility and receipt of a current approved Therapy Plan and current medical records including a diagnosis.  J. Fiscal Responsibilities IDEA, 20 USC, Section 1412 (a)(12)(B)(ii) J.1  J.2  J.3  J.4 When notified by CCS that they are unable to meet a students OT and/or PT needs that are part of the current approved Therapy Plan and have been placed in the students IEP, the LEA shall assume the responsibility to provide the services. In order to claim reimbursement from Los Angeles County CCS, the SELPA shall request approval and a subsequent authorization from the MTP liaison prior to the initiation of the OT and/or PT services. The SELPA shall use CCS paneled employees or CCS paneled contractors who meet standards as qualified PT or OT health care professions. An OT and/or PT shall not provide treatment in lieu of MTP services if he or she is also providing educationally related services to the same student. The SELPA shall ensure that PT and OT treatment services are provided in appropriate space allowing for privacy and using necessary equipment for the provision of medically necessary PT and OT services as prescribed in the approved CCS Therapy Plan. The SELPA shall send documentation of the therapy services to the MTP liaison on a monthly basis in the form of the progress notes. Documentation shall include but not be limited to the dates if service, length of sessions, description of services provided, response to treatment, students functional levels and functional benefits of therapy. The LEA and/or SELPA shall submit a claim for the authorized OT and/or PT services to the Childrens Medical Services, Accounting Dept., 9320 Telstar St., Suite 226, El Monte, CA, 91731 using the Health Insurance Claim Form, HCFA 1500. The MTP shall notify the SELPA liaison and LEA in 10 calendar days when it is unable to meet a students OT and/or PT needs that are part of the current approved MTP Therapy Plan and have been placed in the students IEP. CCS shall provide an authorization to the SELPA liaison upon approval of the OT and/or PT services. The authorization shall indicate the frequency and duration of the services, which shall be reimbursed. The MTP shall provide oversight of the therapy services provided by the SELPA in lieu of the MTP by reviewing the therapy providers progress notes to ensure compliance with the approved MTP Therapy Plan. CCS shall send payment to the SELPA representative indicated on claim cover letter upon receipt of the claim for the treatment services that were provided in compliance with the authorization and the criteria listed in 11c. The reimbursement rate shall not exceed $82 per hour session and $41 per 30-minute session. Therapists will only be reimbursed for treatment services provided. J.5 The MTP therapists shall assess the child and provide recommendations regarding medically necessary therapy at the end of the prescribed period. Upon receipt of the approved Therapy Plan, the MTP liaison shall contact the SELPA liaison to discuss the MTPs ability to meet the students current OT and/or PT needs. Another authorization will be issued to the SELPA liaison if necessary. J.6  The SELPA shall notify the MTP of the date and time of any IEP so that the MTP staff may represent the MTP at the IEP. The SELPA therapy provider may not represent CCS at any IEP. K. Exchange of Information Ca. Code of Regulations, Title 2, Div. 9, Section 60310(3)  K.1  Exchange of information, both verbal and written, shall only be provided with written consent of parent/legal guardian. Consent for release of information form from either the LEA or CCS will be accepted by either agency.  Exchange of information, both verbal and written, shall only be provided with written consent of parent/legal guardian. The written material that can be released from the MTU/MTU-S includes the OT/PT Assessment, OT/PT Therapy Plan, classroom program and MTC dictations. Consent for release of information form from either the LEA or CCS shall be accepted by either agency.  L. Procedural Safeguards Ca. Code of Regulations, Title 2, Div. 9, Section 60550 L.1 If the parent/legal guardian disagrees with the educationally necessary therapy recommendations, the LEA shall inform the parent/legal guardian of the special education due process procedures including their option to stay put.  If the parent/legal guardian disagrees with the medically necessary therapy recommendations, the MTP shall inform the parent/legal guardian of the CCS due process procedures including their option of continuation of services. L.2 CCS and the LEA shall participate in discussion as needed to coordinate care and/or resolve issues for students who are mutually shared.  CCS and LEA shall participate in discussion as needed to coordinate care and/or resolve issues for students who are mutually shared. L.3 All educational OT and/or PT services that are included in the IEP and are not provided by the MTP shall be continued by the LEA pending the education due process. Upon written notification as identified in Title 2, Section 60550, the LEA staff shall participate in due process, complaint investigation and possibly mediation.  Upon written notification by the LEA, all medical OT and/or PT services that are included in the students approved Therapy Plan and IEP and are provided by the MTP, shall be continued by the MTP pending the education due process. MTP staff shall inform the LEA if a student is not receiving continuation of services during an education due process. Upon written notification as identified in Title 2, Section 60550, MTP staff shall participate in due process, complaint investigation and possibly mediation on issues pertaining to CCS. M. Interagency Dispute Resolution IDEA, 20 USC, Section 1412 (a) (12) (B) (ii) M.1 The SELPA liaison shall work to resolve disputes with CCS prior to filing a complaint with either the Secretary of Health and Human Services or the Superintendent of Public Instruction. In the event of an interagency dispute, the following procedures shall be utilized: Upon identification of a disagreement between the SELPA and CCS, the involved parties and their supervisors will meet to resolve the issues within 20 working days. If the issues are not resolved by the aforementioned meeting, the SELPA and CCS administrators involved in the dispute shall clarify the issues through discussion within 20 additional working days. If issues are not resolved by the aforementioned steps, the SELPA and CCS shall jointly refer the issue in writing to the State Department of Health Services, CCS and California Department of Education for a state review and resolution. This step is required if above is attempted without success.  CCS shall work to resolve disputes with the SELPA liaison prior to filing a complaint with either the Secretary of Health and Human Services or the Superintendent of Public Instruction. In the event of an interagency dispute, the following procedures shall be utilized: Upon identification of a disagreement between the SELPA and CCS, the involved parties and their supervisors will meet to resolve the issues within 20 working days. If the issues are not resolved by the aforementioned meeting, the SELPA and CCS administrators involved in the dispute shall clarify the issues through discussion within20 additional working days. If issues are not resolved by the aforementioned steps, the SELPA and CCS shall jointly refer the issue in writing to the State Department of Health Services, CCS and California Department of Education for a state review and resolution. This step is required if above is attempted without success. N. Professional Standards N.1 Maintain standards for providing a free and appropriate education to individuals with disabilities as required by federal and state laws and regulations. LEA/school administration will notify CCS staff in advance of school disaster drills and include CCS staff in emergency preparedness drills.  Maintain standards of practice for physical therapy (PT) and occupational therapy (OT) as recognized by the pediatric rehabilitation and medical community. All CCS staff and volunteers will have been cleared through the state fingerprinting screening requirement. CCS shall ensure that any vendor who comes into direct contact with students shall have another adult present at all times. CCS staff will be notified in advance of school disaster drills and will participate in school emergency preparedness drills.  O. Staff Development Ca. Code of Regulations, Title 2, Div. 9, Section 60310 [c] (11) O.1 The SELPA liaison shall plan joint staff development activities in conjunction with the MTP liaison. These activities are intended to promote interagency understanding as well as to disseminate the intent and content of this agreement. This shall take place at least one time per year.  The MTP liaison shall plan joint staff development activities in conjunction with the SELPA liaison. These activities are intended to promote interagency understanding as well as to disseminate the intent and content of this agreement. This shall take place at least one time per year. P. Review of Interagency Agreement and Procedures Ca. Code of Regulations, Title 2, Div. 9, Section 60310 [c} (13) P.1 The agreement shall be reviewed annually by the SELPA and the MTP liaisons. No additions, deletions, or modifications may be made to this agreement without the joint approval of the parties to the agreement. This document is in effect until replaced by a revised Interagency Agreement, signed by all parties.  The agreement shall be reviewed annually by the SELPA and the MTP liaisons. No additions, deletions, or modifications may be made to this agreement without the joint approval of the parties to the agreement. This document is in effect until replaced by a revised Interagency Agreement, signed by all parties. P.2 At least annually, the SELPA and the MTP liaisons shall review changes in procedures that are relevant to both agencies. At least annually, the SELPA liaison shall provide a list of the names, addresses and telephone numbers of the appropriate SELPA administrators and school district special education administrators to the MTP liaison  At least annually, the SELPA and the MTP liaisons shall review changes in procedures that are relevant to both agencies. At least annually, the SELPA liaison shall provide a list of the names, addresses and telephone numbers of the appropriate MTP contacts to the SELPA liaison. Local Interagency Agreement Between the Santa Clarita Valley Local Plan Area (SELPA) and Los Angeles County California Children Services 2007/2008 This agreement is between the Santa Clarita Valley Special Education Local Plan area (SELPA) and California Childrens Services of Los Angeles County. The purpose of this agreement is to provide guidelines and working procedures for staff and designees of the Santa Clarita Valley SELPA and California Childrens Services of Ls Angeles County. This agreement is entered into in order to provide a systematic, effective continuum of service options to individuals with exceptional needs ages birth to twenty-one years and their parents/legal guardians. The implementation of this agreement will ensure interagency coordination, the timely provision of services and the effective utilization of agency resources to meet the needs of individuals with exceptional needs. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their duly authorized officers in the County of Los Angeles, California. LOS ANGELES COUNTY CHILDRENS MEDICAL SERVICES BY:_________________________________________________ Dated:_________________________________ Shavonda Webber-Christmas, M.P.H. 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